Should You Choose Surgery or Medication for Hemorrhoids During Pregnancy?

Hemorrhoid surgery or medication?

Hello doctor, during my pregnancy, I developed a small lump at the anal area that is neither painful nor itchy.
I only notice slight bleeding when I have hard stools.
Should I take medication to resolve this, or is surgery necessary? I feel uncomfortable with this lump, and after my child is born, she has been experiencing severe constipation, straining to the point of vomiting.
She is now two and a half years old and has normal bowel movements with her meals and formula, but she developed a similar lump at the anal area six months ago.
She doesn't feel anything during bowel movements, and it hasn't affected her.
However, since she is so young and has a similar issue, what should I do?

Yang Mama, 20~29 year old female. Ask Date: 2015/10/19

Dr. Cai Xingzhi reply Surgery

1.
Early-stage internal hemorrhoids can be treated with ligation.
Of course, good dietary and hygiene habits can reduce the occurrence of internal hemorrhoids and prevent their worsening.
2.
For children with constipation, it is advisable to consult a pediatrician to adjust the formula concentration or increase solid foods to improve the child's constipation.
It may not require immediate intervention, but if there are concerns about the development of hemorrhoids, a consultation with a colorectal surgeon can be sought.

Reply Date: 2015/10/19

More Info

When it comes to managing hemorrhoids during pregnancy, the decision between surgery and medication can be complex and should be tailored to the individual’s specific circumstances. Hemorrhoids, which are swollen veins in the rectal area, can be particularly common during pregnancy due to increased pressure on the pelvic blood vessels, hormonal changes, and constipation.
In your case, you mentioned that you have a small, painless growth at the anal area that only bleeds slightly when you have hard stools. This suggests that you may be dealing with a mild case of hemorrhoids. The first line of treatment for hemorrhoids during pregnancy typically involves conservative measures, including dietary changes, increased fluid intake, and the use of over-the-counter topical treatments.
Dietary Changes: Increasing fiber intake can help soften stools and reduce the strain during bowel movements, which is crucial in preventing further irritation of the hemorrhoids. Foods rich in fiber include fruits, vegetables, whole grains, and legumes. Additionally, staying well-hydrated by drinking plenty of water can also help.

Topical Treatments: Over-the-counter creams or ointments specifically designed for hemorrhoids can provide relief from discomfort and help reduce inflammation. These products often contain ingredients like witch hazel or hydrocortisone, which can soothe the area.

Sitz Baths: Taking warm sitz baths can also provide relief. Sitting in warm water for about 15-20 minutes several times a day can help reduce swelling and discomfort.

If these conservative measures do not alleviate your symptoms, or if the hemorrhoids become more painful or problematic, it may be necessary to consult with your healthcare provider about further options.
Surgical Options: Surgical intervention is generally reserved for more severe cases of hemorrhoids that do not respond to conservative treatment. Procedures such as rubber band ligation, sclerotherapy, or hemorrhoidectomy may be considered, but these are usually not recommended during pregnancy unless absolutely necessary due to the potential risks involved.

In your situation, since the hemorrhoid is not causing significant pain or discomfort, and given that you are pregnant, it may be advisable to start with conservative management. Surgery during pregnancy carries risks, including the potential for preterm labor, and is typically avoided unless there are compelling reasons to proceed.

Regarding your child, if she has developed a similar condition, the same conservative measures can be applied. It’s important to monitor her symptoms closely. If she experiences pain, significant bleeding, or if the hemorrhoid becomes larger, it would be wise to consult a pediatrician for further evaluation and management.

In summary, for both you and your child, starting with dietary changes, topical treatments, and lifestyle modifications is the best approach. Surgery should be considered only if conservative measures fail and symptoms worsen. Always consult with your healthcare provider before making any decisions regarding treatment, especially during pregnancy. They can provide personalized advice based on your medical history and current condition.

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